Provider Demographics
NPI:1215544192
Name:FITTS, KIMBERLY GAIL (CPHT)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:GAIL
Last Name:FITTS
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:GAIL
Other - Last Name:HESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:511 N MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:MUENSTER
Mailing Address - State:TX
Mailing Address - Zip Code:76252-2425
Mailing Address - Country:US
Mailing Address - Phone:940-759-2833
Mailing Address - Fax:940-759-2481
Practice Address - Street 1:511 N MAPLE ST
Practice Address - Street 2:
Practice Address - City:MUENSTER
Practice Address - State:TX
Practice Address - Zip Code:76252-2425
Practice Address - Country:US
Practice Address - Phone:940-759-2833
Practice Address - Fax:940-759-2481
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX143085183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician